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Congenital toxoplasmosis

Definition
Congenital toxoplasmosis is a group of symptoms and characteristics caused by infection of the fetus with the organism Toxoplasma gondii.

Causes, incidence, and risk factors

Fetal infection with toxoplasmosis results when a nonimmune pregnant woman is initially infected with toxoplasmosis, or if she has a history of toxoplasmosis during previous pregnancies.

For the mother the disease is generally mild and may not be evident. Infection of the fetus, however, can cause severe problems. Infection early in pregnancy results in more severe problems than later infection.

Congenital toxoplasmosis is characterized by damage to the eyes, nervous system, skin, and ears. The newborn often has a low birth weight, enlarged liver and spleen, jaundice, anemia, petechiae (fine red dots in the skin caused by bleeding of the capillaries), and eye damage evidenced by inflammation of the retina.

Symptoms

Prematurity

Small birth weight infant

Increased or prolonged jaundice

Skin rash (petechiae or ecchymosis) at birth

Signs and tests

The physical examination may show signs of:

Chorioretinitis

Cerebral calcifications

Hydrocephalus

Macrocephaly or microcephaly

Lymphadenopathy

Anemia

Late manifestations (signs and symptoms that occur late in the disease) include:

Seizures

Mental retardation

Various neurological manifestations

Visual impairment

Hearing loss

Tests include:

Prenatal diagnosis maternal antibodies (see antibody titer)

Ultrasound of the abdomen

Amniotic fluid and fetal blood testing

Postnatal diagnosis:

CT scan

Standard ophthalmic examination

Neurological examinations

Antibody studies on cord blood and cerebrospinal fluid

TORCH screen

Treatment

Infection in the pregnant mother can be treated with spiramycin.

Fetal infection (diagnosed during the pregnancy) can be treated with pyrimethamine and sulfadiazine.

Treatment of infants who were infected during their fetal development (congenital toxoplasmosis) typically includes pyrimethamine, sulfadiazine, and leucovorin for one year. Infants are also sometimes given steroids if their vision is threatened or if the protein level in the spinal fluid is high.

Expectations (prognosis)

The outcome depends on severity of the congenital toxoplasmosis.

Complications

Blindness or severe visual disability

Severe mental retardation

Other neurological manifestations

Calling your health care provider

Call for an appointment with your health care provider if you are pregnant and think you are at risk for toxoplasmosis (for example, if you have a cat and are the person who cleans the litter box).

Call for an appointment with your health care provider if you are pregnant and have not received any prenatal care.

Prevention

Prospective or expectant mothers can be serologically tested to determine if they are at risk for toxoplasmosis. Pregnant women who have cats as house pets may increase their risk of developing toxoplasmosis.

They should avoid contact with any materials that are potentially infected with cat feces or that could be contaminated by insects exposed to cat feces (cockroaches, flies, etc.). Meat should be cooked until well done, and the hands should be washed after handling raw meat.

Last revised: December 6, 2012by Simon D. Mitin, M.D.

Medical Encyclopedia

All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.

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